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Medications
Betaxolol hydrochloride (tablets and eye drops) — plans on this site that list it on Tier 4
37 plans published on this site list this drug on Tier 4, grouped by company. Plans are sold by county — the service area under each plan shows where it is offered.
Anthem HealthKeepers
1 plan on this site
- Anthem Medicare Advantage 3 (HMO-POS) — Offered in VA: 50 counties
CareOregon Advantage
1 plan on this site
- CareOregon Advantage Plus (HMO D-SNP) — Offered in OR: Clackamas, Columbia, Jackson, Multnomah, Washington
CenCal CareConnect
1 plan on this site
- CenCal CareConnect (HMO D-SNP) — Offered in CA: San Luis Obispo, Santa Barbara
Contra Costa Health Care Plus (HMO D-SNP)
1 plan on this site
- Contra Costa Health Care Plus (HMO D-SNP) — Offered in CA: Contra Costa
Cox HealthPlans
3 plans on this site
- CMH Medicare Advantage (HMO) — Offered in MO: Cedar, Dade, Dallas, Hickory, Polk
- CoxHealth Medicare Advantage (HMO) — Offered in MO: Barry, Christian, Greene, Lawrence, Stone, Taney, Webster
- Phelps Health Medicare Advantage (HMO) — Offered in MO: Crawford, Dent, Maries, Phelps, Pulaski
Elite Health Plan, Inc.
2 plans on this site
- Elite Core HMO (HMO) — Offered in CA: Los Angeles, Riverside, San Bernardino
- Elite Signature HMO (HMO) — Offered in CA: Los Angeles, Riverside, San Bernardino
Highmark Blue Cross Blue Shield
2 plans on this site
- Highmark Health Options Duals (HMO D-SNP) — Offered in WV: 40 counties
- Highmark Health Options Duals Select (HMO D-SNP) — Offered in DE: Kent, New Castle, Sussex
Highmark Wholecare Medicare Assured
2 plans on this site
- Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) — Offered in PA: 57 counties
- Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) — Offered in PA: 57 counties
Independence Blue Cross
3 plans on this site
- Keystone 65 Preferred Rx (HMO) — Offered in PA: Chester, Delaware, Montgomery
- Keystone 65 Select Rx (HMO) — Offered in PA: Chester, Delaware, Montgomery
- Personal Choice 65 Rx (PPO) — Offered in PA: Chester, Delaware, Montgomery
Kern Family Health Care Medicare (D-SNP)
1 plan on this site
- Kern Family Health Care Medicare (HMO D-SNP) — Offered in CA: Kern
MedCare Partners Health Plan of Texas
3 plans on this site
- MedCare Choice (HMO C-SNP) — Offered in TX: Harris
- MedCare Classic (HMO) — Offered in TX: Harris
- MedCare Focus (HMO C-SNP) — Offered in TX: Harris
PrimeTime Health Plan
3 plans on this site
- PrimeTime Health Plan Aultimate (HMO-POS) — Offered in OH: Carroll, Columbiana, Harrison, Holmes, Mahoning, Medina, Portage, Stark, Summit, Wayne
- PrimeTime Health Plan Classic (HMO-POS) — Offered in OH: Carroll, Columbiana, Harrison, Holmes, Mahoning, Medina, Portage, Stark, Summit, Wayne
- PrimeTime Health Plan Plus (HMO-POS) — Offered in OH: Carroll, Columbiana, Harrison, Holmes, Mahoning, Medina, Portage, Stark, Summit, Wayne
San Francisco Health Plan
1 plan on this site
- SFHP Care Plus (HMO D-SNP) — Offered in CA: San Francisco
Troy Medicare
2 plans on this site
- Troy Medicare (HMO) — Offered in NC: 35 counties
- Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) — Offered in NC: 35 counties
Tufts Health Plan
6 plans on this site
- Tufts Medicare Preferred HMO Basic Rx (HMO) — Offered in MA: Barnstable, Bristol, Middlesex, Norfolk, Plymouth
- Tufts Medicare Preferred HMO Prime Rx (HMO) — Offered in MA: Barnstable, Bristol, Middlesex, Norfolk, Plymouth
- Tufts Medicare Preferred HMO Prime Rx Plus (HMO) — Offered in MA: Barnstable, Bristol, Middlesex, Norfolk, Plymouth
- Tufts Medicare Preferred HMO Smart Saver Rx (HMO) — Offered in MA: Bristol, Essex, Norfolk, Plymouth, Suffolk
- Tufts Medicare Preferred HMO Value Rx (HMO) — Offered in MA: Barnstable, Bristol, Middlesex, Norfolk, Plymouth
- Tufts Medicare Preferred PPO RX (PPO) — Offered in MA: Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, Worcester
UCLA Health Medicare Advantage Plan
2 plans on this site
- UCLA Health Medicare Advantage Prestige Plan (HMO) — Offered in CA: Los Angeles
- UCLA Health Medicare Advantage Principal Plan (HMO) — Offered in CA: Los Angeles
Verda Health Plan of Texas
2 plans on this site
- Verda Noble Care (HMO) — Offered in TX: Collin, Dallas, Denton, Tarrant
- Verda Noble Chronic Care (HMO C-SNP) — Offered in TX: Collin, Dallas, Denton, Tarrant
VillageCareMAX
1 plan on this site
- VillageCareMAX Medicare Select Advantage Plan (HMO) — Offered in NY: Bronx, Kings, Nassau, New York, Putnam, Queens, Richmond, Westchester
A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage.
Source: CMS Prescription Drug Plan Formulary data + this site's published plan records · List built 2026-11-08